Project II: Treatment for Triadic Eye Gaze This research is part of larger program project designed to examine behavioral milestones, or cusps, that are critical for developing successful communicative interactions. The purpose of this particular research is to examine a treatment for teaching triadic eye gaze (TEG) to children with motor impairments. Triadic eye gaze (looking back and forth between an adult and object, with or without accompanying gestures and vocalizations) is an important milestone that emerges in typically developing babies around 8-10 months. This behavior reflects the baby's ability to convey coordinated attention between an object of desire and a communicative partner. It has been viewed as the first form of intentional communication and has been linked to later language development. For young children with motor impairments, triadic eye gaze can serve to establish the beginning of purposeful communication, when other signals are difficult to produce, making it a critical cusp in their development. Specifically, this research will document the efficacy of a treatment protocol designed to teach triadic eye gaze to young children with moderate to severe motor impairments. The research will utilize a randomized controlled research design to examine the differences in learning triadic eye gaze in 25 children receiving treatment versus 25 children not receiving treatment (delayed treatment group). The research will document how much treatment is necessary to achieve a high proportion of productions of triadic eye gaze during communication opportunities with adults. Further, the research will explore whether child characteristics (i.e., risk factors including severity of motor impairment, oculomotor problems and/or cognition) are related to the amount of treatment. Finally, the research will examine if TEG emerges in stages: without and then with gestures and vocalizations, and how TEG is related to later symbolic communication. The ultimate importance of this research is the systematic documentation of a program to teach early signals of communication to young children with moderate to severe motor impairments. This project will provide information about how young children with significant disabilities develop communication. The outcomes of this research should assist professionals in knowing how to enhance the communication of these children so that they might better interact with family, teachers and caregivers.